13 August 2019

Red Cross doctors make history as they perform first-of-its-kind heart procedure in Africa

Young Ruveshni was born with one ventricle, resulting in her heart being unable to pump oxygen-poor blood back to her lungs. But a landmark procedure – the first of its kind to be performed in Africa – has changed her life.

In a cutting-edge cardiac intervention at the Red Cross War Memorial Children’s Hospital in Cape Town, a six-year-old girl from George received a non-surgical medical procedure that is the first to be performed in Africa, and only the third successfully completed globally. 

Ruveshni Lewis was born with one heart ventricle, which resulted in her heart unable to pump oxygen-poor blood (“blue blood”) back to her lungs.

Oxygen-poor blood returns from the body to the heart through two main veins known as the superior vena cava (SVC) and inferior vena cava (IVC).

Cardiac surgeons performed two previous operations and were able to divert blue blood via a conduit directly to the lungs, without it having to pass through the missing ventricle, but following a second operation, a hole or “window” between the conduit and her heart remained open.

This caused too much blue blood to flow back to her heart. The complication led to Ruveshni having to undergo an emergency operation.

Fewer repeat surgical procedures

The hospital’s catheterisation laboratory team implanted an Atrial Flow Restricter (AFR) device last week, between one of the heart chambers and the conduit to reduce the window size from 10mm to 4mm – a more normal size – explained paediatric cardiologist Professor Rik de Decker.

The new device was recently developed in Sweden and isn’t on the market yet. “The device is currently undergoing registration in Europe and we got it on a compassionate-use basis, gratis,” said De Decker.

“It has a hole inside, like a blow-off hole to allow some blood to go through. After undergoing six previous procedures, the implantation of the AFR effectively means that Ruveshni won’t need to undergo difficult repeat surgery for this problem, which is wonderful news."

A spring in her step 

Little Ruveshni has been recovering well after the procedure. Her mother, Justine Lewis, is delighted with her recovery and says that Ruveshni is happy and full of life since the procedure.

“Mentally and physically she’s a playful child. She wasn’t like that – she couldn’t play long, she couldn’t walk long distances, she would always complain about getting tired too easily – but that has all changed,” she said.

Image: Bertram Malgas, EWN


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